• Journal of Korean Neurosurgical Society
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• 제55권4호
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• pp.222-225
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• 2014

Traumatic intracranial aneurysms (TICAs) are rare and are associated with high rates of morbidity and mortality. TICAs usually result from head injuries caused by traffic accidents, industrial accidents, or gunshots. We report a traumatic aneurysm of the callosomarginal artery-cortical artery junction arising from a penetrating injury by scissors. A 51-year-old woman was admitted to our hospital after suffering a penetrating injury caused by scissors. Computed tomography (CT) and CT-angiography demonstrated a right orbital roof fracture, subarachnoid hemorrhage, frontal lobe hemorrhage, intraventricular hemorrhage, and a traumatic aneurysm of the right callosomarginal artery-cortical artery junction. We trapped the traumatic aneurysm and repositioned a galeal flap. Postoperative CT showed a small infarction in the left frontal lobe. Follow-up angiography two months later showed no residual aneurysm. We suggest that an aggressive surgical intervention be performed whenever TICA is diagnosed.

• Journal of Chest Surgery
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• 제25권3호
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• pp.283-288
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• 1992

From january 1970 through december 1990, 130 cases of patients with chest penetrating injury were admitted to department of thoracic and cardiovascular surgery in Chosun University Hospital. We analyzed above patients and obtained results were as follows: 1. The ratio of male to female was 7.1:1 in male predominance, and the majority[69.6%] was distributed from 2nd to 3rd decade. 2. The most common cause of chest penetrating injuries was stab wound. 3. 110 cases[84.5%] were arrived to our emergency room within six hours after trauma. 4. The most common injuring mode was hemo, pneumothorax. 5. The frequently injured site of the penetrating chest trauma was left side of the chest [64.65%]. 6. The common associated injuries of penetrating chest injuries were extremities injuries, abdominal injuries, head & facial injuries. 7. The common method of surgical treatment were closed thoracostomy[78 cases], open thoracotomy[20 cases], laparatomy[12 cases]. 8. The overall motality was 3.07%[4/130], and the causes were hypovolemic shock, sepsis and asphyxia.

• 대한기관식도과학회지
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• 제4권1호
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• pp.142-147
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• 1998

Retained wooden foreign bodies following penetrating trauma are a difficult diagnostic problem. However, penetrating wooden foreign bodies of head and neck have the potential for misinterpretation or failure to detect such foreign bodies on CT. Given the likelihood that such a miss will result in an abscess or neurovascular injury, we present the method with higher window settings, they had a higher attenuation with a unique striated internal architecture and different Hounsfield numbers readily differentiate air and non-air hypodense material such as fat, or possibly wood. Being aware of the potential appearance of wood, we may also find CT useful in excluding small retained fragments in postoperative patients with persistent symptoms. This article presents two cases in which wooden foreign bodies of head and neck were present with CT evaluation.

• Journal of Korean Neurosurgical Society
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• 제48권1호
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• pp.73-78
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• 2010

Objective : Streptococcus pyogenes is a beta-hemolytic bacterium that belongs to Lancefield serogroup A, also known as group A streptococci (GAS). There have been five reported case in terms of PubMed-based search but no reported case of brain abscess caused by Streptococcus pyogenes as a result of penetrating skull injury. We present a patient who suffered from penetrating skull injury that resulted in a brain abscess caused by Streptococcus pyogenes. Methods : The patient was a 12-year-old boy who fell down from his bicycle while cycling and ran into a tree. A wooden stick penetrated his skin below the right lower eyelid and advanced to the cranium. He lost consciousness on the fifth day of the incident and his body temperature was measured as $40^{\circ}C$. While being admitted to our hospital, a cranial computed tomography revealed a frontal cystic mass with a perilesional hypodense zone of edema. There was no capsule formation around the lesion after intravenous contrast injection. Paranasal CT showed a bone defect located between the ethmoidal sinus and lamina cribrosa. Results : Bifrontal craniotomy was performed. The abscess located at the left frontal lobe was drained and the bone defect was repaired. Conclusion : Any penetrating lesion showing a connection between the lamina cribrosa and ethmoidal sinus may result in brain abscess caused by Streptococcus pyogenes. These patients should be treated urgently to repair the defect and drain the abscess with appropriate antibiotic therapy started due to the fulminant course of the brain abscess caused by this microorganism.

• Journal of Korean Neurosurgical Society
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• 제66권5호
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• pp.598-604
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• 2023

Penetrating head injury is a serious open cranial injury. In civilians, it is often caused by non-missile, low velocity flying objects that penetrate the skull through a weak cranial structure, forming intracranial foreign bodies. The intracranial foreign body can be displaced due to its special quality, shape, and location. In this paper, we report a rare case of right-to-left displacement of an airgun lead bullet after transorbital entry into the skull complicated by posttraumatic epilepsy, as a reminder to colleagues that intracranial metal foreign bodies maybe displaced intraoperatively. In addition, we have found that the presence of intracranial metallic foreign bodies may be a factor for the posttraumatic epilepsy, and their timely removal appears to be beneficial for epilepsy control.

• Journal of Chest Surgery
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• 제28권12호
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• pp.1167-1173
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• 1995

We evaluated fifty three cases of traumatic diaphragmatic injuries that we have experienced from Jan.1973 to Oct.1994. The age distribution of the pateint was ranged from 1 to 74 years. Sex ratio is 39:14 with male dominence. The traumatic diaphragmatic injuries were due to blunt trauma in 37[Left 22, Right 15 cases and penetrating trauma in 16[Left 9, Right 7 cases. In blunt trauma, Preoperative diagnosis of the diaphragmatic injuries was possible in 27 patients[72% , and in penetrating trauma, 14 patients[88% . Among 37 in blunt traumas, 22[58% cases, and among 16 in penetrating traumas, 13[88% cases were operated within 24 hours. The most common herniated abdominal organ in the thorax was stomach[14/53 . The traumatic diaphragmatic repair of 50 cases were performed by thoracic approach in 23 cases, thoracoabdominal approach in 8 cases and abdominal approach in 19 cases, and in 3 cases, not operated. Hospital mortality [including not operated patients[3 was 17%[9/53 and the causes of death were intracranial hematoma[1 , hypertensive encephalopathy[1 and asphyxia[1 , and among operated patients[6 , combined head injury[2 , multiorgan failure[2 , hypovolemic shock[1 , and pulmonary edema & renal failure[1 . All deaths had related to the severity of associated injuries.

• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1538-1541
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• 2000

Apenetrating head injury by an arrow is extremely rare being only two cases reported in the literature. We report a case of 12-year-old boy who presented with an arrow lodged at the posterior fossa through nasal nostril. He was slightly drowsy, but neurologically intact except a sixth nerve palsy in the left eye. Brain CT showed no intracerebral hemorrhage. The arrow was entered through the right nostril and the tip was stucked in the left cere-bello-pontine angle through the sphenoid sinus. We removed the arrow without craniotomy since the tip was verified smooth and no cerebral arteries were in contact with the arrow. The patient recovered well without any significant complications. The sixth nerve palsy resolved completely after six months. The verification of the shape of the offending material, a retrograde removal of the arrow in the direction of its line of trajectory, and an identification of adjacent cerebral arteries seem to be important in the management of this type of injury.

• Journal of Trauma and Injury
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• 제31권2호
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• pp.82-86
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• 2018

Craniocerebral gunshot injuries (CGIs) are extremely seldom happened in Korea because possession of individual firearm is illegal. So, CGIs are rarely encountered by Korean neurosurgeons or Korean trauma surgeons, though in other developing countries or Unites states of America their cases are indefatigably increasing. Management goal should focus on early aggressive, vigorous resuscitation. The treatments consist of immediate life salvage through correction of coagulopathy, intracranial decompression, prevention of infection and preservation of nervous tissue. There have been few studies involving penetrating CGIs in Korea. Here we present a case of penetrating gunshot wound in Korea. We present a 58-year-old man who was unintentionally shot by his colleague with a shotgun. The patients underwent computed tomography (CT) for assessment of intracranial injury. The bullet passed through the left parietal bone and right lateral ventricle and exited through the posterior auricular right temporal bone. After CT scan, he arrested and the cardiopulmonary resuscitation was conducted immediately. But we were unable to resuscitate him. This case report underscores the importance of the initial clinical exam and CT studies along with adequate resuscitation to make the appropriate management decision. Physicians should be familiar with the various injury patterns and imaging findings which are poor prognostic indicators.

• Journal of Korean Neurosurgical Society
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• 제51권3호
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• pp.164-166
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• 2012

Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.

• Journal of Trauma and Injury
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• 제35권4호
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• pp.277-281
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• 2022

Craniocerebral gunshot injuries is gradually increasing in the civilian population with a worse prognosis than closed head trauma. We experienced a case of craniocerebral gunshot injury which a bullet penetrating from the submandibular area into the clivus of a patient. The patient did not show any symptom. However, serial laboratory findings showed an increase in blood lead level. We removed foreign bodies without any problems using an endoscopic transnasal transclival approach. Due to the extremely low frequency, guidelines for definitive management of gunshot injuries have not been presented in Korea yet. We introduce our surgical experience of a craniocerebral gunshot injury with an unusual approach for removing intracranial foreign bodies.