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Child 10 years old had
accidental bullet injury follow by a fall on ground,
massive bleeding from occipital region. Brain CT scan
show a bullet arrested at posterior cranial fossa.
During surgery a bullet traction carefully after small
incision above her cranial wound and muscle separations.
Postoperatively the patient very well so discharge to
home.
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Brain CT scan show a bullet arrested at posterior
cranial fossa
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Brain CT scan (bone window) show a bullet arrested at
posterior cranial fossa |
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30 years old female
had fall on ground more than 5 meter height,
follow by sudden loss of consciousness. Brain CT scan
show large collection right parieto-occipital extradural
hematoma with overlaying linear fracture extended to the
base of skull. Surgery was done immediately to evacuate
the extradural hematoma after craniotomy flap.
Postoperatively the patient return awake without any
neurological deficit.
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Brain CT scan show large collection right parieto-occipital
extradural hematoma
Brain CT scan show linear fracture extended to the base
of skull |
Brain CT scan show right parieto-occipital linear
fracture
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21 years old male
exposed to cranial bullet injury perforating his skull
from left side. Brain CT scan show sever depress
fracture with a bullet arrested at left temporal lobe,
which have centre of speech. Completely removed of a
depress segment, evacuation of hematoma, extraction of
the bullet with dural patching was done during surgery.
After surgery he was talking and walking normally.
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Brain CT scan show
depress fracture with a bullet arrested at left
temporal lobe
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Brain CT scan (bone window) show a bullet arrested at
left temporal lobe
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19 years old male
exposed to
perforated
cranial bullet injury for his skull
from left side and exit from right side with loss of his
consciousness. Brain CT scan show a tract of hematoma
extend from entrance to exit sit. Completely removal of
a depress segment, evacuation of hematoma with dural
patching was done during surgery. After surgery he was
gradual improvement within ten days and return to his
consciousness .
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Brain CT scan
a tract of hematoma extend from entrance to exit sit
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Brain CT scan
after two week show disappear of a tract of hematoma
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33 years old male presented as a
case
of road traffic accident with completely loss of
his consciousness. Brain CT scan show a depress segments
at left frontal region with involving left orbit.
Completely removal of a depress segment, reconstruction
of the orbital margin with dural patching was done
during surgery. After surgery he is gradual improvement
and completely return his consciousness.
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Brain CT scan
fracture involving left orbit
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Brain CT scan
a depress segments at left frontal region
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25 years old male
had cranial shell injury with completely loss of
his consciousness. Brain CT scan show a depress segments
seated at left temporal region with extensive intracerebral and intraventricular hemorrhage.
Completely removal of a depress segment, evacuation of
hematoma with dural patching was done during surgery.
After surgery he is gradual improvement completely
return to consciousness.
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Brain CT scan
a depress segments with intracerebral hemorrhage
at left temporal region
Brain CT scan at 7 postoperative day show disappears of
depress segments, intracerebral, intraventricular
hemorrhage
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Brain CT scan
extensive intraventricular hemorrhage
at left temporal region
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63 years old male
had a headache,
inability to walking and lastly loss of consciousness
for one weak. He has history of mild head trauma before
one month. Brain MRI show a big left sided subdural
hematoma. A burr hole was done for evacuation of
hematoma. Immediately after surgery the patient return
oriented and he became able to walk.
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Brain MRI show
a big left sided subdural hematoma
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Brain MRI show
a big left sided subdural hematoma
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Child 10
years old had Head trauma with large
screw driver penetrating his skull.
Brain
CT scan revealed the screw driver penetrated about one inch
inside his brain. Urgent surgical
intervention
was done to remove the
screw driver carefully under general
anesthesia with repair of
the brain damage. In the first postoperative day, he was very
well with no serious complications.
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skull x-ray
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Brain CT
scan screw
driver penetrated
brain
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30 years old male exposed to road traffic
accident. He had breathing difficulty with loss
of the
ability to move both legs. Urgent chest tube inserted
to evacuate blood collection inside the chest . Dorsolumbar
MRI
showed severe fracture at D8-D9
with spinal cord compression. Internal vertebral column
fixation with spinal cord decompression was done.
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dorsal
x-ray
showed
fracture at D8-D9 |
MRI
showed
fracture at D8-D9
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49
years old male had multiple intracranial shell injury. He was
confused with impairment of vision. Brain CT scan
showed two inlet at left
occipital area, one of them impacted in the bone and the other
perforated and arrested at the right parietal lobe.
Immediate surgery was done:
1-Removal of left shell.
2-Craniectomy at left occipital bone with dural patch
(site of shell entrance).
3-Craniotomy to the right parietal bone for evacuation
of intracerebral hematoma.
After 3 days, he got good improvement in his vision.
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Brain CT scan 1st entrance
site
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Brain CT scan 2nd entrance site
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30
years old male had motor cycle accident, presented to
emergency unit with coma and
bleeding from the right ear. Brain CT scan showed large
right temporal extradural hematoma compressing the
brain temporal side. Urgent craniotomy was done with
evacuation of brain hematoma.
He improved and discharged home in a full
consciousness in the 8th postoperative day.
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Brain CT scan
right
temporal extradural hematoma |
Right
temporal extradural hematoma
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Child 5
years old presented with
sudden
fall on the ground
when he was playing outside his home. His family thought that someone hit
their child. On examination he was unconscious with
small wound on his vertex, left dilated pupil (very
dangerous sign of brain injury). Brain CT scan showed
bullet arrested at left temporal lobe with tract
hematoma from vertex.
Left sub temporal
craniectomy was done, extraction of bullet and
evacuation of hematoma. In the 1st
postoperative day, he became conscious but still
unable to talk and weakness in the right
side. In the 2nd postoperative day ,he
started talking with gradual increase in the power of right
side. After one month, he was completely returned back to normal
activity with freely talking and walking.
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Brain CT scan site of entrance
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Brain CT scan
bullet
arrested at left temporal |
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Child
7
years old had a mild road traffic accident. No loss
of consciousness ,no vomiting. Brain CT scan showed
normal. In the next day, the patient was very
well, eating and walking normally. Repeated brain CT
scan showed same results. After 2 days he started
to have headache, repeated vomiting with attacks of
generalized fit, not responding to antiepileptic therapy.
On examination, the patient was very risky, he was
unconscious with right dilated pupil (very dangerous
sign of brain herniation). Brain CT scan showed very big
right intracerebral hematoma with intraventricular haemorrhage. Immediate surgical intervention, right
frontal craniotomy with evacuation of intracerebral
hematoma, homeostasis, external ventricular drain to
evacuate intraventricular blood. At 2nd
postoperative day ,the right pupil retained to normal
size but still had inability to move eye ball(
oculomotor palsy). The external ventricular drain became
clear and it was removed. The patient kept under
courses of aggressive physiotherapy. He was gradually
improved. After one month
seemed very well with an ability to talk and walk.
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Brain CT scan 28-10-06
Brain CT scan intracerebral
haemorrhage
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Brain CT scan
29-10-06
Brain CT scan disappear
intracerebral haemorrhage |
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17
years old male had
Intracranial shell injury, inlet site from
right occipital area and arrested at left thalamus causes
tract hematoma with intraventricular
haemorrhage.
on arrival to the causality he was unconscious
with pinpoint
pupils and left side weakness .
Operated on for evacuation of intracerebral hematoma,
removal of bone pieces with external ventricular drain. He
was improved postoperatively.
5th day, the Patient developed repeated vomiting
because of blocking of the external shunt with
clot. and shunt revision was done.
9th day
started to develop complications, he was
feverish with neck stiffness and loss of
consciousness. Removal of the external drain and cover with powerful antibiotics. The patient gradually
improved and he became conscious .on the 33rd day he
discharged home .
After one year he was
speech
difficulty and spastic limbs. Brain CT scan showed
hydrocephaly with periventicular oedema. frontal
ventriculoperitoneal
shunt was done. In the postoperative day, he was
able to speak frankly with normal gait.
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Brain CT scan
sequences
Shell entrance site
Shell arrested site
ventricular drain disappear
intraventricular haemorrhage
after 3 month Brain CT scan
show diluted ventricules
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Intraventricular hemorrhage
Postop. remove of depress seg.
with ventricular drain
Removable ventricular drain
frontal
ventriculo-peritoneal shunt |
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42 years old male had a depressed occipital fracture with
injury to the posterior third of the superior sagital
sinus. He was presented to causality as severe bleeding
from the wound with blindness. During surgery severe multiple, depressed
segments was found causing partial tear to posterior
third of the superior sagital sinus. He received 5 pints
of blood within 30 min, removal of bony pieces, dural
suturing was done. In the 4th
postoperative day ,his vision improved ,so he discharged home.
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Brain CT scan fracture site |
Brain CT scan bone window |
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