Stephanion to cranial base penetrating stab wound with outstanding recovery: A case report

Author:

Abdulsada Alkawthar M.1,Ismail Mustafa2,Elsayed Abdelrahman Mohamed3,Emara Mohamed R.4,Al-Khazaali Younus M.5,Albairmani Sama S.6,Muthana Ahmed7,Hoz Samer S.8

Affiliation:

1. Department of Neurosurgery, Azerbaijan Medical University, Baku, Azerbaijan,

2. Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq,

3. Faculty of Medicine, Mansoura University, Mansoura, Egypt,

4. University of Sharjah, College of Medicine, Sharjah, United Arab Emirates,

5. Department of Neurosurgery, University of Al-Nahrain, College of Medicine, Baghdad, Iraq,

6. Department of Neurosurgery, University of Al-Iraqia, College of Medicine, Baghdad, Iraq,

7. Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,

8. Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, United States.

Abstract

Background: Mortality due to head trauma is common in developed countries in all age groups. Nonmissile penetrating skull base injuries (PSBIs) due to foreign bodies are quite rare, accounting for about 0.4%. PSBI carries that a poor prognosis brainstem involvement usually is often fatal. We are reporting the first case of PSBI with a foreign body insertion site through the stephanion with a remarkable outcome. Case Description: The 38-year-old male patient was referred with a penetrating stab wound to the head through the stephanion caused by a knife after a conflict in the street. He had no focal neurological deficit or cerebrospinal fluid leak, and Glasgow coma scale (GCS) was 15/15 on admission. A preoperative computed tomography scan showed the path of the stab beginning at the stephanion, which is the point where the coronal suture crosses the superior temporal line, heading toward the cranial base. Postoperatively, GCS was 15/15 without any deficit apart from the left wrist drop, possibly due to a left arm stab. Conclusion: Careful investigations and diagnoses must be made to ensure convenient knowledge of the case due to the variety of injury mechanisms, foreign body characteristics, and individual patients’ characteristics. Reported cases of PSBIs in adults have not reported a stephanion skull base injury. Although brain stem involvement is usually fatal, our patient had a remarkable outcome.

Publisher

Scientific Scholar

Subject

Neurology (clinical),Surgery

Reference15 articles.

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