Successful management of a Comatose Patient with Traumatic Brain Exposure with a fronto-Parieto-occipital flap
Composite skull defects in patients with severe head injuries are very challenging to manage. The dilemma when deciding whether to perform a definitive reconstruction is how long to wait for physiological recovery before an intervention complicates the situation. The inability of such patients to to...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Traumatology
2020-03-01
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| Series: | Journal of Trauma and Injury |
| Subjects: | |
| Online Access: | http://www.jtraumainj.org/upload/pdf/jti-2019-037.pdf |
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| Summary: | Composite skull defects in patients with severe head injuries are very challenging to manage. The dilemma when deciding whether to perform a definitive reconstruction is how long to wait for physiological recovery before an intervention complicates the situation. The inability of such patients to tolerate prolonged anesthetic exposure is a driving factor for performing the minimal intervention necessary to facilitate recovery. Herein, we present a case involving the successful immediate reconstructive treatment of a severely head-injured adolescent with a composite scalp defect secondary to trauma. A 14-year-old boy sustained a severe head injury from a motor vehicle accident with a composite scalp defect in the right fronto-parietal region. The frontal lobe was exposed, and the right eye was crushed and devitalized. The patient was deeply unconscious for 3 days, without any significant improvements before reconstructive surgery was proposed due to fear of possible meningitis resulting from the exposure of brain structures. We successfully managed the patient with a fronto-parieto-occipital flap, after which the patient promptly recovered consciousness. |
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| ISSN: | 1738-8767 2287-1683 |