Treatment strategies and prognostic analysis for craniocerebral penetrating injury
ZOU Min-gang
ZHOU Chun-hao
XIE Cheng
LI Wei
JIANG Qiu-hua
HUANG Qian-liang
Abstract：Objective To explore the standardized treatment strategies for craniocerebral penetrating injury caused by non-firearm foreign body.Methods A retrospective analysis was performed on the clinical data of 16 patients with non-firearm foreign body craniocerebral penetrating injury treated at Ganzhou People's Hospital from January 2017 to June 2024.Based on the foreign body location and imaging characteristics,personalized surgical interventions were carried out,including craniotomy for foreign body removal(10/16),neuronavigation-assisted removal(4/16),and endonasal endoscopic removal(2/16).The presence of residual foreign bodies was assessed within 24-48 h postoperatively by CT or MRI,vascular protection was evaluated within 7 d after surgery by CTA or DSA,and perioperative complications were recorded.Neurological functional prognosis was assessed using the Glasgow Outcome Scale(GOS)at 90 d postoperatively.Results The entry sites of foreign bodies included the orbital compartment(7 cases),frontal region(4 cases),parietal region(3 cases),and nasal region(2 cases).All the 16 patients successfully underwent surgery.The clearance rate of foreign bodies within 24-48 h postoperatively reached 15/16.CTA or DSA performed within 7 d after surgery revealed no new blood vascular injury.Perioperative complications included new neurological deficits(3 cases),delayed traumatic intracranial hematoma(one case),cerebrospinal fluid rhinorrhea(2 cases),epileptic seizure(one case),intracranial infection(2 cases),and brain abscess(one case);all were alleviated after targeted intervention.At 90 d postoperatively,10 patients had achieved good recovery(GOS score 5),4 had moderate disability(GOS score 4),and 2 had severe disability(GOS score 3);there were no cases of death or vegetative state.Conclusions The management of non-firearm foreign body craniocerebral penetrating injury should be based on multidisciplinary collaboration,combined with precise imaging evaluation and individualized surgical strategies.Early removal of the foreign body,rigorous cerebral dura mater repair,and intensified antinfective management are crucial for optimizing outcomes.
Keywords：Head injuriespenetratingForeign bodiesNeurosurgical proceduresNeuronavigationNeuroendoscopesPrognosis
Publication Date：2025-09-25
Online Publishing Date：2025-10-28(First online date of this platform, not the publication date of the document)
Pages：8( 820-827 )