Anesthetic Management of a Rare Penetrating Traumatic Brain Injury Caused by a Pickaxe: A Case Report

• 作者: Cassandra Tocko Ferdinand Ndom Ntock Gaspary Fodjeu Gérard Beyiha Jacqueline Ze Minkande Joel Noutakdie Tochie Junette Arlette Metogo Mbengono Mathieu Motah
• 来源期刊: 麻醉学期刊(英文)
• 学科: 医学
• 关键词: TRAUMATIC Brain INJURY PENETRATING Pickaxe ANESTHESIA
• 年，卷（期）: 2019,（8）
• 页码范围: 155-165
• 页数: 11页
• 分类号: R73

摘要

Penetrating traumatic brain injuries (TBI) are frequent neurosurgical emergencies, associated with a high mortality rate and we almost no previous report on a penetrating pickaxe TBI. Herein, we report and discuss the anesthetic challenges encountered in the surgical extraction a pickaxe from a patient with TBI. We present the case of a 34-year-old man who with a penetrating pickaxe TBI at his left temporal region, signs of raised intracranial pressure and normal vital signs. Anesthetic management began within 3 hours of admission and consisted of general anesthesia and rapid sequence intubation. Surgical extraction of a 14 cm long wing of the pickaxe was achieved with good hemostatic control. His postoperative course was marked by complete blindness of the right eye till one year of follow-up. The authors highlight the need of a prompt multidisciplinary management with close perioperative monitoring of haemostatic control and signs of raised intracranial pressure as key factors for a favourable postoperative outcome.