Concealed Penetrating Parietal Lobe Injury Due to Stab Wound: Case Report

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Austin J Emergency & Crit Care Med. 2014;1(1): 2.

Concealed Penetrating Parietal Lobe Injury Due to Stab Wound: Case Report

Enver Sösüncü1, Hakan AK2*, Ismail Gülsen1, Yurdanur Akyüz3 and Mehmet Arslan1

1Department of Neurosurgery, Yüzüncü Yil University, Turkey

2Department of Neurosurgery, Bozok University, Turkey

3Department of Radiology, Bozok University, Turkey

*Corresponding author: Hakan Ak, Department of Neurosurgery, Bozok University, School of Medicine, Yozgat, Turkey

Received: July 11, 2014; Accepted: August 22, 2014; Published: August 26, 2014


Penetrating brain injury may occur as a result of the bullets shrapnel parts of gunshot wounds, wood, knife, and glass. Thick and hard structure of the skull protects the brain from external forces. However, relatively thin structures roof of orbital cavity, temporal bone, and cribriform plate make the brain susceptible to penetrating injury. These injuries mostly occur in maxillofacial region. Herein, we present a penetrating parietal lobe injury due to stab wound.

Keywords: Penetrating brain injury; Stab wound; Knife; Parietal lobe


Thick and hard structure of skull protects the brain from external forces, however, in rare instances penetrating brain injury may occur depending on the severity of trauma [1]. This type of injury may occur in every period of life. Glass, knife, wood, metal splinters and bullet injuries are the some examples in the etiology of these injuries [1-4]. Penetrating brain injury may lead to serious vascular and neurologic deficits such as intracerebral hematoma, cerebral contusion, intraventricular hemorrhage, pneumocephalus, brain stem injury, and fistula of carotid-cavernous sinus [5,6].

Most of the penetrating head injuries by stab wound are visible. However the concealed penetrating head Injuries are rare and the diagnosis is easily missed. Herein, we report a parietal lobe injury due to stab wound after assaulting in a 29 year old man whose diagnosis was made fortuitously and who recovered without any neurological deficit.

Case Presentation

A 29 year-old man attended to the emergency room due to assaulting. In the physical examination there were multiple scalp injuries due to stabbing. There was not any foreign body on the scalp (Figure 1). Neurological examination was normal. In spite of normal neurological examination, brain computed tomography (CT) was received and it revealed a foreign body looks like tip of knife blade on the right parietal region. It was extending about 2,5cm to inside of brain parenchyma it was showing close neighborhood with sagittal sinus (Figure 2 & 3). However, we didn’t perform angiography in spite of close neighborhood. Patient was hospitalized and underwent operation under general anesthesia. Craniectomy with drilling around knife was performed. Dural tear was extended. After that knife was removed with gentle manipulation (Figure 4 & 5). We didn’t see any complication in the postoperative period like hemorrhage or neurologic deficit. Patient was discharged without any deficit.