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Journal : Medical Scope Journal (MSJ)

Penetrating Head Injury by a Key: A Case Report Oley, Maximillian C.; Prasetyo, Eko; Tjungkagi, Ferdinan; Manuhutu, Yovanka N.; Sitorus, Edwin H.
Medical Scope Journal Vol. 7 No. 2 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i2.59224

Abstract

Abstract: Penetrating head injury is defined as head trauma caused by an object that penetrates the skull and the underlying duramater. We reported a 22-year-old man who came to the hospital with a motorcycle key stuck into the back of his head after a fight with his friend approximately one hour before admission. The patient was fully conscious. History of projectile vomiting, and seizures were denied, and there were no other neurological deficits. Blindly removing the key can damage the neural tissue and can cause secondary injury to the brain and surrounding blood vessels. The primary goal of treatment for patients with suspected traumatic brain injury is to prevent secondary brain injury and infection. The removal of the object safely, debridement of the damaged parenchyma, removal of the hematoma, and closure of the injured dura and skin are the main goals of surgical treatment for penetrating head injuries. In this case, motor key evacuation was performed followed by craniotomy and debridement. The prognosis was good, and there was no neurological deficit. In conclusion, complete and adequate care is essential for patients with penetrating brain injuries. The strategy for treating these injuries is primarily surgery with the aim of preventing secondary brain injury and infection. According to existing research, antibiotics should be given for an indefinite period after surgery. Keywords: penetrating head injury; motorcycle key
Scalp Defect of Cranioplasty with Titanium Mesh: A Case Report Sonbay, Antonius E.; Prasetyo, Eko; Oley, Maximillian C.; Manuhutu, Yovanka; Tjungkagi, Ferdinan
Medical Scope Journal Vol. 7 No. 2 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i2.59703

Abstract

Abstract: Several implant materials for cranioplasty have been studied, including autologous bone, titanium mesh, polyetheretherketone (PEEK), and polymethyl methacrylate (PMMA). Titanium mesh is believed to have excellent biocompatibility, low cost, and satisfactory cosmetic effects, especially in three-dimensional (3D) custom-made meshes. We reported a 54-year-old man complaining of open wound in his left temporoparietal region since a month. Blood tests showed leukocytosis. Patient was diagnosed as scalp infection with previous cranioplasty using bone cement on temporoparietal region. The patient underwent scalp reconstruction with skin flap, removing skin defect, and split thickness skin graft (STSG) from left thigh. Patient was provided with outpatient medication consisting of analgesics and broad-spectrum antibiotics. Follow-up assessment 14 days after surgery did not reveal any secondary infections on titanium mesh implant and skin flap. The main complications of cranioplasty, in addition to the studied aesthetic results, are represented by the risk of infection, postoperative hematoma, impaired wound healing, as well as prolonged failure due to transplant absorption or infection, as a result of which the prosthesis needs to be removed. In conclusion, titanium mesh is still a better choice of material for cranioplasty in many factors such as price, accessibility, infection rate, and biocompatibility Keywords: scalp; cranioplasty; head injury; prosthesis