Unusual penetrating head injury in children: personal experience and review of the literature.

INTRODUCTION: A penetrating head injury belongs to the most severe traumatic brain injuries, in which communication can arise between the intracranial cavity and surrounding environment.

DISCUSSION: The authors present a literature review and typical case reports of a penetrating head injury in children. The list of patients treated at the neurosurgical department in the last 5 years for penetrating TBI is briefly referred. Rapid transfer to the specialized center with subsequent urgent surgical treatment is the important point in the treatment algorithm. It is essential to clean the wound very properly with all the foreign material during the surgery and to close the dura with a water-tight suture. Wide-spectrum antibiotics are of great use. In case of large-extent brain damage, the use of anticonvulsants is recommended.

CONCLUSION: The prognosis of such severe trauma could be influenced very positively by a good medical care organization; obviously, the extent of brain tissue laceration is the limiting factor.