Penetrating Head Injury by Traditional Agriculture Tool

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Résumé

Abstract
Introduction: Penetrating head injuries are mostly caused by aggression. The type of weapon used and the subsequent anatomical structures injured often occasion its particular clinical, therapeutic and evolutive characteristics. We report the management case of penetrating head injury by an “unusual” object.
Methods: We describe a case of a penetrating brain injury by a traditional agricultural tool admitted in the department of Neurosurgery of the Ouagadougou University Teaching Hospital in April 2017.
Observation: A 14-year-old admitted in the Neurosurgery Department following 26 hours of head injury by a local agricultural tool « DABA ». On examination, patient had a GCS
of 8 (E2V1M5), febrile, right hemiplegia, a left frontoparietal and parasagittal penetrating head injury with the metal blade tucked. CT scan showed a large metallic artefact, a bone
fragment at the entry point, hemorrhagic contusion and diffuses edema. Complete blood count showed leukocytosis with predominantly neutrophils, clotting profile showed low prothrombin. The penetrating metal was removed 20 hours following admission and an eventful post op evolution characterized by septicemia on post op day 5 and subsequently death post op day 10.
Conclusion: The immediate prognosis of penetrating brain injures is dependent on the different anatomical structures that were severed by the penetrating object. The principal
complication in the short and long term is infection.

Mots-clés

Penetrating brain injury • Infection