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KMID : 1144620200330010048
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Journal of Trauma and Injury
2020 Volume.33 No. 1 p.48 ~ p.52
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Successful Management of a Comatose Patient with Traumatic Brain Exposure with a Fronto-Parieto-Occipital Flap
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Maduba Charles Chidiebele
Nnadozie Ugochukwu Uzodimma
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Abstract
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Composite skull defects in patients with severe head injuries are very challenging to manage. The dilemma when deciding whether to perform a definitive reconstruction is how long to wait for physiological recovery before an intervention complicates the situation. The inability of such patients to tolerate prolonged anesthetic exposure is a driving factor for performing the minimal intervention necessary to facilitate recovery. Herein, we present a case involving the successful immediate reconstructive treatment of a severely head-injured adolescent with a composite scalp defect secondary to trauma. A 14-year-old boy sustained a severe head injury from a motor vehicle accident with a composite scalp defect in the right fronto-parietal region. The frontal lobe was exposed, and the right eye was crushed and devitalized. The patient was deeply unconscious for 3 days, without any significant improvements before reconstructive surgery was proposed due to fear of possible meningitis resulting from the exposure of brain structures. We successfully managed the patient with a fronto-parieto-occipital flap, after which the patient promptly recovered consciousness.
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KEYWORD
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Composite scalp defect, Head injury, Flap, Unconsciousness
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