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Cranial Impalement of a Falling Fence Spike in a Child: A Case Report

Received: 11 February 2016    Accepted: 26 February 2016    Published: 6 May 2016
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Abstract

Cranial impalement injuries are rare. They occur from a variety of objects, and via different mechanisms. We describe the case of a 5-year old boy who suffered cranial impalement injury via a unique mechanism. He presented to our centre with an impacted 17.8cm long metallic rod (a fence spike) in the vertex of his cranium, just off the midline. The spike penetrated his head and broke off its supporting frame as the frame was falling off a collapsing brick fence. He was transported as soon as possible to the hospital by relatives, without any attempt to remove the impaled spike. An urgent cranial computerized tomogram was done, and the object was removed under general anaesthesia in the operating theatre. The patient had complete recovery and was subsequently discharged from the hospital, with no residual neurological deficit. This case demonstrates a rare mechanism of cranial impalement. It also highlights the importance of following basic principles in the management of such injuries.

Published in Journal of Surgery (Volume 4, Issue 2)
DOI 10.11648/j.js.20160402.16
Page(s) 31-34
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Penetrating Head Injury, Foreign Object, Metallic Rod, Brick Wall, Cranio-facial

References
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[2] S. W. Kim, S. K. Youn, J. T. Kim, S. H. Cho, Y. H. Kim, and K. T. Hwang, “Management of an Unusual Craniofacial Impalement Injury by a Metallic Foreign Body,” Journal of Craniofacial Surgery, vol. 23. pp. e140–e146, 2012.
[3] J. Koestler and R. Keshavarz, “Penetrating head injury in children: a case report and review of the literature,” The Journal of Emergency Medicine, vol. 21. pp. 145–150, 2001.
[4] A. Kumar, H. Singh, and K. C. Sharma, “Penetrating head injury from a pedestal fan rotor blade in a child - An unusual case,” Pediatr. Neurosurg., vol. 42, pp. 391–394, 2006.
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[6] S. K. Aremu, M. M. Makusid, and I. C. Ibe, “Oro-cranial penetrating pencil injury,” Ann. Saudi Med., vol. 32, pp. 534–536, 2012.
[7] W. W. Chan and K. A. Choudhari, “Penetrating head injury caused by a dart,” Ir. Med. J., vol. 101, 2008.
[8] S. KAWAMURA, H. HADEISHI, N. SASAGUCHI, A. SUZUKI, and N. YASUI, “Penetrating Head Injury Caused by Chopstick —Case Report—,” Neurologia medico-chirurgica, vol. 37. pp. 332–335, 1997.
[9] A. Lauterbach, R. Hausmann, and P. Betz, “Fatal impalement injury of the head due to a curtain rail,” Int. J. Legal Med., vol. 120, pp. 380–382, 2006.
[10] D. Pappano, E. Murray, L. B. Cimpello, and G. Conners, “Penetrating missile-type head injury from a defective badminton racquet,” Eur. J. Pediatr., vol. 168, pp. 749–751, 2009.
[11] A. Walls, M. Pierce, H. Wang, and E. H. Harley, “Clothing hanger injuries: pediatric head and neck traumas in the United States, 2002-2012.,” Otolaryngol. Head. Neck Surg., vol. 150, pp. 300–4, 2014.
[12] M. Miscusi, P. Arangio, L. De Martino, F. De-Giorgio, P. Cascone, and A. Raco, “An unusual case of orbito-frontal rod fence stab injury with a good outcome.,” BMC Surg., vol. 13, no. 1, p. 31, Jan. 2013.
[13] H. Inoue, N. Hitosugi, T. Cho, K. Kamishima, T. Kanayama, K. Ogawa, T. Arai, Y. Kuno, M. Tsuchida, and Y. Okuda, “A case of craniofacial injury by javelin,” Japanese J. Anesthesiol., vol. 55, pp. 1416–1419, 2006.
[14] N. C. H. Keong, J. R. W. Gleave, and P. J. Hutchinson, Neurosurgical history: Comparing the management of penetrating head injury in 1969 with 2005., vol. 20. 2006, pp. 227–232.
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Cite This Article
  • APA Style

    Jimoh Abdullahi Onimisi, Guga Dung Apollos, Mathew Mesi, Danjuma Sale. (2016). Cranial Impalement of a Falling Fence Spike in a Child: A Case Report. Journal of Surgery, 4(2), 31-34. https://doi.org/10.11648/j.js.20160402.16

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    ACS Style

    Jimoh Abdullahi Onimisi; Guga Dung Apollos; Mathew Mesi; Danjuma Sale. Cranial Impalement of a Falling Fence Spike in a Child: A Case Report. J. Surg. 2016, 4(2), 31-34. doi: 10.11648/j.js.20160402.16

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    AMA Style

    Jimoh Abdullahi Onimisi, Guga Dung Apollos, Mathew Mesi, Danjuma Sale. Cranial Impalement of a Falling Fence Spike in a Child: A Case Report. J Surg. 2016;4(2):31-34. doi: 10.11648/j.js.20160402.16

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  • @article{10.11648/j.js.20160402.16,
      author = {Jimoh Abdullahi Onimisi and Guga Dung Apollos and Mathew Mesi and Danjuma Sale},
      title = {Cranial Impalement of a Falling Fence Spike in a Child: A Case Report},
      journal = {Journal of Surgery},
      volume = {4},
      number = {2},
      pages = {31-34},
      doi = {10.11648/j.js.20160402.16},
      url = {https://doi.org/10.11648/j.js.20160402.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20160402.16},
      abstract = {Cranial impalement injuries are rare. They occur from a variety of objects, and via different mechanisms. We describe the case of a 5-year old boy who suffered cranial impalement injury via a unique mechanism. He presented to our centre with an impacted 17.8cm long metallic rod (a fence spike) in the vertex of his cranium, just off the midline. The spike penetrated his head and broke off its supporting frame as the frame was falling off a collapsing brick fence. He was transported as soon as possible to the hospital by relatives, without any attempt to remove the impaled spike. An urgent cranial computerized tomogram was done, and the object was removed under general anaesthesia in the operating theatre. The patient had complete recovery and was subsequently discharged from the hospital, with no residual neurological deficit. This case demonstrates a rare mechanism of cranial impalement. It also highlights the importance of following basic principles in the management of such injuries.},
     year = {2016}
    }
    

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    AB  - Cranial impalement injuries are rare. They occur from a variety of objects, and via different mechanisms. We describe the case of a 5-year old boy who suffered cranial impalement injury via a unique mechanism. He presented to our centre with an impacted 17.8cm long metallic rod (a fence spike) in the vertex of his cranium, just off the midline. The spike penetrated his head and broke off its supporting frame as the frame was falling off a collapsing brick fence. He was transported as soon as possible to the hospital by relatives, without any attempt to remove the impaled spike. An urgent cranial computerized tomogram was done, and the object was removed under general anaesthesia in the operating theatre. The patient had complete recovery and was subsequently discharged from the hospital, with no residual neurological deficit. This case demonstrates a rare mechanism of cranial impalement. It also highlights the importance of following basic principles in the management of such injuries.
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Author Information
  • Neurosurgery Division, Department of Surgery, Ahmadu Bello University Teaching Hospital, PMB 06, Shika-Zaria, Kaduna State, Nigeria

  • Neurosurgery Division, Department of Surgery, Ahmadu Bello University Teaching Hospital, PMB 06, Shika-Zaria, Kaduna State, Nigeria

  • Neurosurgery Division, Department of Surgery, Ahmadu Bello University Teaching Hospital, PMB 06, Shika-Zaria, Kaduna State, Nigeria

  • Department of Surgery, Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria

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