狩猟用散弾銃による穿通性頭部外傷の一例  [in Japanese] Penetrating brain injury after gunshot wound to the head : Case Report  [in Japanese]

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Author(s)

Abstract

<p>A patient over 60 years old who had suffered gunshot wound to the head was transported to our hospital by emergency medical helicopter service. Computed tomography (CT) revealed the bullet had entered from the right parietal region, penetrated the brain, and lodged in the left parietal bone, leaving numerous bone and metal fragments scat-tered within the brain. Acute subdural hematoma (ASDH) on the left side had caused midline shift. Emergency decompressive craniectomy was performed to remove the hematoma and extract the bullet. Acute brain swelling occurred during dural closure, so evacuation of the necrotic brain and extensive duroplasty with artificial dura were also performed. Unfortunately, the patient died of central herniation the day after surgery. As gun ownership is strictly regulated under the Firearms and Swords Law, gunshot wounds are extremely rare in Japan. In particular, treatment of gunshot wounds to the head is hardly ever experienced. ASDH is rare after gunshot wound to the head, with only one case on the entry side, but the present case occurred on the opposite side to the point of entry. In general, ASDH is caused by tearing of the bridging veins in the subdural space and/or bleeding from the contusional brain. In the present case, the subdural hematoma on the opposite side to the point of entry was caused by continuous bleeding from the left parietal bone fracture extending into the subdural space through the dura tear.</p><p>Knowledge of the treatment of patients with gunshot wounds to the head may become more important in the future in Japan. We report this case along with a review of the pertinent literature.</p>

Journal

  • Neurotraumatology

    Neurotraumatology 39(1), 37-40, 2016

    The Japan Society of Neurotraumatology

Codes

  • NII Article ID (NAID)
    130007836918
  • Text Lang
    JPN
  • ISSN
    0389-5610
  • NDL Article ID
    027688606
  • NDL Call No.
    Z43-435
  • Data Source
    NDL  J-STAGE 
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