Traumatic Cerebral Aneurysm Due to Speargun Injury

XCEPT in unusual cases, 3 treatment of penetrating wounds of the brain consists of craniotomy and debridement, with primary closure of the dura and scalp. With expeditious treatment, complications are surprisingly few; infections such as meningitis and brain abscess are the most frequent problems. Traumatic cerebral aneurysms, however, do not even appear among the complications listed in a series of 879 casualties sustaining penetrating wounds of the brain during the Korean conflict, 4 and very few cases have been reported from civilian practice. 2 The following report describes the successful treatment of a traumatic cerebral aneurysm complicating a most unusual penetrating wound of the brain. Case Report A 6-year-old Filipino girl was accidentally shot in the right frontal region of the head with a rubber-band-powered speargun (Fig. 1), used for fishing in Bulacan Province, Luzon, Republic of the Philippines. The steel arrow penetrated the right frontal lobe and could not be extracted because the barb on its tip caught on the inner table of the calvarium, and the child was therefore brought to the hospital. Examination. The child was obtunded but responded to those who spoke her dialect. Except for a slight left facial weakness, the rest of the neurologic examination was normal. The child was somewhat malnourished, weighing only 24 lbs. The steel arrow had been cut off leaving a 2-in. length of the shaft extending from the right frontal region. Radiographs of the skull (Fig. 2) indicated that the arrow had penetrated at least 2 inches into the right frontal lobe.