WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Reber Saeed Yousif and Walid W. H. AL-RAWI

ABSTRACT

Background: The common causes of penetrating head injury (pHI) are well established all over the world,penetrating traumatic brain injuries (PTBIs) are low-velocity injuries which can be caused by a variety of tools,they carry a worse prognosis. We received four unusual cases to our Emergency room ER with a special rotatoryhigh speed cutting machine KOSARA used by workers, prognosis was different according to clinical presentationand initial management of the patient. Methods: a retrospective study of cases of low-velocity Rotatorypenetrating head injuries by KOSRA, four cases were recorded in our department. Results: Our 4 cases wereaccidental penetration by a heavy rotating tool KOSARA (a sharp high-speed rotatory cutting metal instrumentused for cutting plastics, metals, woods, ceramics, etc.). all cases were male no female affected, Three cases adulttow middle age, one old age, one case young child. 2 cases with an orbito-cranial penetrating injury, with visionloss of the affected side, one of them had orbital evisceration, one case exhibited limb weakness. All four caseswere operated by craniotomy and they needed support in the intensive care unit ICU,, the foreign object for threecases and was removed surgically. only for the child was removed by his parents. plain X-ray, Computedtomography scan and angiography of the head were obtained in all patients.fortunately no one died. all were doingwell at the most recent follow-up. There have been neither signs of meningitis, infection or seizures duringadmission period. All were kept on broad-spectrum antibiotics as well as prophylactic antiepileptic drugs, thendischarged home. Conclusions: The presenting picture of penetrating injury to the head may be daunting, all wereresulting from personal neglection and carelessness and not following instructions of safety maneuver steps duringworking. We applying the advanced trauma life support protocol in ER, acquiring the needed preoperativeneuroimaging studies, and finally performing a planned stepwise surgical intervention through craniotomy incollaboration with ophthalmologist and faciomaxillary surgeon, yield an excellent functional recovery.

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