title: Management and outcome of low velocity penetrating head injury caused by impacted foreign bodies.
abstract: BACKGROUND
  Penetrating head injuries with impacted foreign bodies are rare, associated with a high incidence of morbidity and potentially life-threatening. In this study, we aimed at investigating the outcome of these cases as well as analyzing the factors affecting the prognosis.
  
  
  METHODS
  A retrospective study in which the records of 16 patients who had penetrating head injuries caused by low-velocity impacted foreign bodies were revised. All patients were males with a mean age of 28.9 years (range, 18 to 50 years). The follow-up period ranged from 4 to 13 months with a mean of 8.1 months. Causes of injury were construction accidents in 6 (37.5 %) patients, assault in 6 (37.5 %) and road traffic accidents in 4 (25 %). The impacted objects included a bar of iron, a piece of wood, a nail, a sickle and a piece of glass. Diagnostic computerized tomography (CT) of the brain was carried out on admission in all patients. Thirteen (81.3 %) patients were submitted to surgery, and all had the appropriate management in the form of antibiotics and dehydrating measures as required. The primary outcome measure was the Glasgow Outcome Scale (GOS) at the end of follow-up.
  
  
  RESULTS
  At the end of follow-up, ten (62.5 %) patients had a GOS score of 5, two (12.5 %) patients had a score of 4, and four (25 %) patients had a score of 1.
  
  
  CONCLUSIONS
  Low-velocity penetrating head injuries are most common in young adult males. With the appropriate management, a majority of even the most severe cases can have a favorable outcome.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Alexandria University, Champollion Street, El Khartoum Square, Azareeta, Alexandria, Egypt. waelmmosa@yahoo.com.
authors.forename: Wael Mohamed Mohamed
authors.initials: WM
authors.lastname: Moussa
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Alexandria University, Champollion Street, El Khartoum Square, Azareeta, Alexandria, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abbas
mesh_terms: D000293:Adolescent; D000328:Adult; D005547:Foreign Bodies / Q000150:complications / Q000628:therapy*; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D020197:Head Injuries, Penetrating / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Foreign body; Head injury; Impacted; Low velocity; Penetrating