A #neurosurgery #medtwitter case from #scientissimum. A 34-year-old male presented to the emergency room neurologically intact after sustaining a stabbing to the left temporal region. A CT of the head showed that the knife had penetrated the left temporal bone, left sphenoid 🧠
bone, left pterygopalatine fossa, and left maxillary sinus. A computed tomography angiogram (CTA) showed no obvious vascular injury, but the process was limited due to streak artifact. The patient was taken to the operating room for the planned removal of the knife under 💀
endoscopic visualization and wound debridement. The patient was then taken to the endovascular suite where digital subtraction angiography (DSA) showed a left distal internal maxillary artery and proximal middle meningeal artery injury. 🔪
The left distal internal maxillary artery and proximal middle meningeal artery were embolized with Onyx due to active bleeding. The postoperative head CT showed a very small left temporal lobe hemorrhage with a small amount of pneumocephalus without any hydrocephalus.🏥
The patient was extubated on post-injury day one without any cranial nerve palsies or other neurologic deficits and was discharged on postoperative day two.🧑🏿⚕️
Case credit medicalpedia on IG.
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