Penetrating Brain Injury : a Case Report of 17 Years Old Man with a Penetrating

Brain Injury due to Fish Bow

Eggy Jita Pradana*, MD ; Donny Kusuma Wardhana**, MD, Neurosurgery Division

Saiful Anwar Hospital, Medical Faculty of Brawijaya University

Abstract

BACKGROUND: Penetrating Brain Injury is part of head trauma. Penetrating Traumatic Brain Injury (PTBI)
is the most deadly head injury. About 70-90% of these victims died before arriving at the hospital, and
50% died during resuscitation efforts at the Emergency Room. These injuries are the result of the energy
transferred by objects to the human skull and towards the brain.

CASE DESCRIPTION: A 17-year-old male patient complained of pain due to a fish bow stuck in the frontal
region with a 0.3 cm wound diameter. CT scan showed foreign body with metal density, penetrated the
frontal lobe on the midline side with a depth of 6 mm, through a 0.3 cm defect on the anterior and
posterior wall right frontal sinus. The patient came without neurological deficits and has been through
the trepanation, craniectomy and evacuation of the foreign body.

CONCLUSION: Treatment in traumatic brain injury is performed less than 24 hours to prevent infection
and damage to the brain parenchyma. An accurate diagnostic process is needed to determine the need
of operation, CT scan with 3D reconstruction is chosen as a diagnostic tool from this case. Craniectomy is
performed to evaluate and prevent damage and injury of the vascular during the evacuation process.

KEYWORD : Foreign bodies, Penetrating Traumatic Brain Injury, Trepanation, Craniectomy.