The management of impalement brain injury is very challenging, because of its complexity, risk of intracranial infection, neurological damage and functional impairment of the affected persons; in addition to the paucity of standardised treatments guidelines. The objective of this paper was to describe the clinical presentation and management outcome of patients admitted with impalement brain injuries in our centre. Data of all patients with traumatic brain injury from January 2015 to November 2018 was collated from hospital medical record department and theatre operation register. Records of patients with impalement brain injury managed within the aforementioned period were extracted. We managed 5 cases (0.26%) of impalement cranio-cerebral injuries out of the total 1913 cases of traumatic brain injury managed over the study period. All the patients were males with a mean age of 28 years. Alteration in the level of consciousness and bleeding scalp wound with impaled object were the main presenting symptoms. Three of the patients were presented in coma. The injury resulted from different causes and variable objects implicated. The impaled objects identified included iron-rod, metallic part of Dane gun, multi-faceted spear, piece of stone and a piece of charred wood. Both the right and left sides of the cranium was equally affected with a case involving midline frontal area. Craniectomy around the impaled object was used to remove the objects, two patients had good recovery whilst three succumbed to the injuries, one died from disseminated intravascular coagulopathy and the two were from aspiration pneumonitis complicated by respiratory failure. Impalement cranio-cerebral injury accounted for about 0.3% of all cases of traumatic brain injury in our environment. Variable impaled objects were found affecting a different part of the cranium and postoperative outcome depends largely on the preoperative neurological status.

中文翻译：

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刺伤性脑损伤：连续5例临床报告

病灶性脑损伤的治疗非常具有挑战性，因为它的复杂性，颅内感染的风险，神经系统损害和受影响人的功能受损；除了缺乏标准化的治疗指南。本文的目的是描述在我们中心接受脑损伤的患者的临床表现和治疗结果。将2015年1月至2018年11月期间所有颅脑外伤患者的数据从医院病历部门和战区手术登记处进行整理。提取了在上述期间内管理的患有颅脑损伤的患者的记录。在研究期间，我们共处理了1913例颅脑外伤，其中5例（0.26％）累及了颅脑损伤。所有患者均为男性，平均年龄为28岁。主要的症状是意识水平的改变和被刺伤的头皮伤口出血。其中三名患者呈昏迷状态。伤害是由不同的原因和涉及的可变对象导致的。确定的刺穿物体包括铁棍，戴恩枪的金属部分，多面长矛，一块石头和一块烧焦的木头。颅骨的左右两侧均受一例涉及中线额叶区域的影响。用颅骨切除术切除穿刺物，两名患者康复良好，三名因伤致死，一名死于弥散性血管内凝血病，两名死于吸入性肺炎并发呼吸衰竭。刺入式颅脑损伤约占我们环境中所有颅脑损伤病例的0.3％。发现可变的受刺物体影响颅骨的不同部位，术后结果在很大程度上取决于术前神经系统状况。