TITLE:
Anesthetic Management of a Rare Penetrating Traumatic Brain Injury Caused by a Pickaxe: A Case Report
AUTHORS:
Junette Arlette Metogo Mbengono, Ferdinand Ndom Ntock, Joel Noutakdie Tochie, Cassandra Tocko, Gaspary Fodjeu, Mathieu Motah, Gérard Beyiha, Jacqueline Ze Minkande
KEYWORDS:
Traumatic Brain Injury, Penetrating, Pickaxe, Anesthesia
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.9 No.8,
August
23,
2019
ABSTRACT: 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 of a pickaxe from a patient with TBI. We present the case of a 34-year-old man who presented 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.