Penetrating Traumatic Brain Injury, Presentation, Diagnosis And Management: A Case Series.

Abstract

Background:  Penetrating traumatic brain injury, a far less prevalent subset of traumatic brain injury, is defined as any insult resulting in violation of the skull, dura, and brain by a foreign object. It besets tangential, penetrating, and perforating injuries. It carries a far worse prognosis than blunt traumatic brain injury with higher rates of morbidity and mortality. Management is aimed at controlling hemorrhage, reducing intracranial pressure, preventing infections, debridement of devitalized tissue, and removal of any foreign bodies lodged therein.  Objective:  To present a case series of penetrating traumatic brain injuries as seen at Kenyatta National Hospital.  Methods: Sequential cases of patients managed with penetrating brain injury were reviewed. Results: 3 cases were identified, ages ranging from 16 - 57‬ years. The male-to-female ratio was 2:1 with the majority being young adults. The missile to non-missile ratio was 2:1. All patients were managed surgically after initial evaluation and resuscitation. One of the patients unfortunately succumbed while the rest fully recovered and were discharged home. ‬‬‬‬‬‬‬‬‬Conclusion: Penetrating traumatic brain injuries remain a relevant and catastrophic cause of morbidity and mortality, but prompt and adequate diagnosis and management can lead to great outcomes.