title: Trans-nasal-trans-sphenoidal brain injury by a fencing foil: an unusual case report and brief literature review.
abstract: In this report, the authors present an unusual case of a 10-year-old child who suffered a severe headache and rhinorrhea that occurred as a result of fencing foil sports injury via trans-nasal-trans-sphenoidal (TNTS) pathway. Following trauma, the child had shown neurological symptoms such a pupil dilatation, change in consciousness and mild hemiparesia. Imaging demonstrated destruction of bone structures including posterior wall of sphenoid sinus and antero-superior part of sella turcica, and also a contusion at right thalamic region. For treatment of rhinorrhea lumbar drainage system (LDS) had planted in order to relieve cerebrospinal fluid (CSF) leakage. After the treatment, the patient had fully recovered without any need of further surgical intervention. CSF leakage had prevented and neurological symptoms were completely treated. This case represents the first report of brain injury via TNTS pathway in a sports practice. Diagnosis, clinic follow-up and treatment options of this rare accidental sports injury are discussed.
authors.affiliation: Clinic of Neurosurgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ministry of Health, Ankara, Turkey - rftozay@hotmail.com.
authors.forename: Rafet
authors.initials: R
authors.lastname: Özay
authors.affiliation: Clinic of Neurosurgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ministry of Health, Ankara, Turkey.
authors.forename: Mehmet S
authors.initials: MS
authors.lastname: Balkan
authors.affiliation: Clinic of Neurosurgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ministry of Health, Ankara, Turkey.
authors.forename: Çağhan
authors.initials: Ç
authors.lastname: Tönge
authors.affiliation: Clinic of Neurosurgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ministry of Health, Ankara, Turkey.
authors.forename: Zeki
authors.initials: Z
authors.lastname: Şekerci
mesh_terms: D001265:Athletic Injuries / Q000175:diagnosis / Q000601:surgery*; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D006801:Humans; D008297:Male; D012658:Sella Turcica / Q000000981:diagnostic imaging / Q000293:injuries*; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging / Q000293:injuries*; D013788:Thalamus / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014951:Wounds, Stab / Q000000981:diagnostic imaging / Q000601:surgery*